Glickman Symposium Asks "Why Not Zero Suicides?"

On September 15th at MaineHealth, the 10th Annual Glickman Family Center for Child & Adolescent Psychiatry Symposium provided a collaborative educational day for nearly 170 people, focusing on preventing suicide. With the rate of suicide increasing across age groups in Maine and nationally, suicide is truly a public health epidemic. Among teenage girls, suicide hit a 40-year high recently. In girls aged 10 to 14, suicides tripled. In Maine, suicides outnumber homicides 10 to 1.

Robyn Ostrander, MD, Interim Chief of Psychiatry at Maine Medical Center and Chair of the Glickman Family Center for Child & Adolescent Psychiatry at Spring Harbor Hospital, opened the symposium with a presentation titled “The Lay of the Land on Youth Suicide, Maine vs. the U.S.” An overwhelming accumulation of research indicates that two-thirds of suicides involve an impulsive decision leading to action within minutes to hours. Studies also find that 95% of suicide attempt survivors live out their lives naturally. The implication for restricting access to lethal means, such as firearms, and quality crisis intervention is profound.

Keynote speaker M. Justin Coffey, MD, FAPA, CHCIO, of the Menninger Clinic and Baylor College of Medicine in Houston Texas, continued the momentum of the day with a riveting presentation called “Managing Information to Achieve Zero Suicides.” He shared the model for Perfect Depression Care founded at Henry Ford Health Systems in Michigan, a model that has been spreading for over a decade across the country, taken on by health systems, counties, even entire states. Data he presented on an 85% sustained reduction in suicides in the Henry Ford system proved that achieving zero suicides is an essential and attainable goal. He reinforced community partnerships as a means to preventing suicide, especially when local governments are invested.

Afternoon breakout sessions included, “Healthy Communities: Screening for childhood ACEs” co-presented by Rebecca Hoffmann Frances, LMFT, Director of Clinical Innovation at Maine Behavioral Healthcare and Steve DiGiovanni, MD, Director of MMP Primary Care Clinics at Maine Medical Center. “Addressing adverse childhood experiences is critical to addressing suicide, and quality of life and health. We’ve been collecting data on the exposure of childhood trauma in Maine, and our state statistics are high when compared to the national statistics: one in four Mainers experience two or more types of trauma in their childhood,” explains Frances.

There is strong correlation between ACEs and health effects. When there is an increase in the number of ACES, there is a higher risk for chronic disease like COPD and diabetes. When children have four or more ACES, it is imperative to screen for mental health impacts like PTSD, mood disorders, substance use, anxiety and depression. “The earlier that you provide coping skills, the better the chances are of interrupting the adoption of high risk behaviors. For instance, a social emotional curriculum in schools focused on learning how to have healthier relationships will teach kids how to deal with conflict,” said Frances.

A workshop on social media use in youth was led by Maine Medical Center child psychiatrist Erin Belfort, MD, who talked about the relationship between risk taking behaviors and social media usage. Dr. Belfort described the social media channels teenagers use. Heavy teen users, or about 26% of teens, engage in 16.5 hours of social media a day. “They are almost constantly connected, so how do we help kids find balance and middle ground?” asks Dr. Belfort. Kids are not always thinking about future consequences, so we as parents and clinicians must help guide youth on what to do if they hear about or see someone on social media who appears to be struggling or unsafe.

“Patient Centered Care: Evidence-based Depression Care for Youth” was the third workshop presented by Roslyn Gerwin, DO, Director of the Pediatric Psychiatry Consultation service at Barbara Bush Children’s Hospital at Maine Medical Center. “Evidence-based treatment is an essential part of clinical care, but optimal treatment should always be individualized and ideally involve shared decision making,” explained Gerwin.

The Symposium closed with a personal and practical discussion of the survivors of a suicide, and the ripple effect that runs through individuals and the community. Exposure to trauma either directly or indirectly is a common occupational hazard in healthcare, and providers are not immune to trauma’s effects. Including caregivers, like mental health professionals, as survivors in need of consideration and care, is key. Why and how to care for survivors, including our colleagues and ourselves, is essential to our work.

The Glickman Symposium was made possible over the last decade by the generosity of Spring Harbor donors Judith Glickman Lauder and the late Albert Brenner Glickman. This year’s event was additionally supported by the Maine Behavioral Health Partnership, Maine Council on Child and Adolescent Psychiatry, MaineHealth, and Maine Medical Center.